Jan132023
Book excerpt

“The ideology that is institutionalized in medicine requires that we interpret all illness as pointless. By ‘pointless’ I mean that it can play no role in helping us live our lives well. Illness is an absurdity in a history formed by the commitment to overcome all evils that potentially we can control. I suspect that this is one of the reasons we have so much difficulty dealing with chronic illness — it should not exist but it does. It would almost be better to eliminate the subjects of such illness rather than to have them remind us that our project to eliminate illness has made little progress.

“It is only against this background that we can appreciate the widespread assumption that what we can do through the office of science and medicine we ought to do. Whereas it used to be a physician’s first obligation not to act, we now believe our commitment to the abolition of limits makes the physician’s first obligation to act through the office of medicine. As a result, physicians lose their freedom to care for the sick because they are now judged by the predictability of their performance; physicians must now provide a ‘cure’ based on the assumption that what is ‘wrong’ with the sick can be traced to specific ‘causes.’ The patient becomes the consumer, and thus ‘the old conception of medicine as a collaborative enterprise, in which doctor and patient each have freedoms and responsibilities, can no longer be sustained.’ [quotation from Oliver O’Donovan, Begotten or Made? Clarendon Press, 1984]

“One of the most disturbing aspects of this change is the assumption that a medicine so formed needs no justification. We assume that we ought to do what we can do because such is the way of compassion. But as Oliver O’Donovan reminds us in Begotten or Made? compassion is hardly a virtue that can stand by itself. ‘Compassion is the virtue of being moved to action by the sight of suffering — that is to say, by the infringement of passive freedoms. It is a virtue that circumvents thought, since it prompts us immediately to action. It is a virtue that presupposes that an answer has already been found to the question “What needs to be done?”’ When compassion becomes the overriding virtue in a world in which we believe that human inventiveness has no limits, the result can only be the increasing subjection of our lives to a technology grown cruel by its Promethean pretensions.”

— from Stanley Hauerwas, Naming the Silences: God, Medicine, and the Problem of Suffering (Eerdmans, 1990).

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